Hospital Acquired Venous Thromboembolism: A Preventability Assessment

Area of Science:

• Healthcare Quality Improvement
• Patient Safety
• Thrombosis Research

Background:

• The American Heart Association aims to reduce hospital-acquired venous thromboembolism (HA-VTE) by 20% by 2030.
• Quality improvement efforts increasingly target potentially preventable HA-VTE.
• This study determined the proportion of HA-VTE events that are potentially preventable.

Purpose of the Study:

• To quantify the proportion of hospital-acquired venous thromboembolism (HA-VTE) events that are potentially preventable.
• To identify key factors contributing to the preventability of HA-VTE.

Main Methods:

• Retrospective, single-center pilot study involving 50 patients with HA-VTE.
• Identification of seven preventability factors, focusing on VTE prophylaxis prescription and administration.
• Systematic chart review using a standardized data collection form to extract data.

Main Results:

• Potentially preventable HA-VTE occurred in 40% of cases.
• Missed doses of VTE prophylaxis were observed in 29.8% of patients, with patient refusal cited in 71% of these instances.
• Delays in prophylaxis initiation occurred in 12.7%, and 60% of patients on mechanical prophylaxis showed nonadherence.

Conclusions:

• Forty percent of hospital-acquired VTE cases were deemed potentially preventable.
• Missed doses of VTE prophylaxis represent the most common preventability factor.
• Patient refusal is the leading cause of missed VTE prophylaxis doses, highlighting a critical area for intervention.